This one belongs to the phenylalkylamine class of CCBs, which makes it the most cardioselective of them all. The consequence of this is an increased serum level of drugs such as cyclosporine and digoxin. Additionally, both inhibit CYP3A, as well as P-glycoprotein-mediated drug transport into tissues.

The level of attention received by these drugs in this chapter reflects their importance in the mortality statistics. On the other hand, verapamil and diltiazem can actually stop your heart. The dihydropyridine blockers have little effect on the myocardium, and therefore their toxicity is usually limited to lowish blood pressure and constipation, which are rarely ICU-level problems. The lethal ones are verapamil and diltiazem.

All are highly protein bound: the volume of distribution is large for verapamil (5.5L/kg) and dialtiazem (5.3L/kg).Removal by dialysis is not an option.

All undergo at least partial hepatic metabolism.All are well absorbed orally (this feature makes them popular antihypertensives).

Pharmacological properties of commonly used calcium channel blockers Additional resources should include the LITFL CCC entry, which is clear and concise. The cardinal differences in these two toxicological syndromes are discussed at the very end of this chapter, which otherwise mainly deals with calcium channel blockers on their own. An ideal resource for answering such a question can be found in DeWitt and Waksman's article from Toxicological reviews (2004) - they basically answer the college question for you. Question 9 from the first paper of 2020 presented calcium channel blocker overdose as the main point of discussion, and Question 14 from the second paper of 2006 asked the candidates to compare beta blockers and calcium channel blockers in a 'compare and contrast' table.

Antidote for beta blocker overdose